1. Albuminuria Testing in Hypertension and Diabetes
- Author
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Jung-Im Shin, Alex R. Chang, Morgan E. Grams, Josef Coresh, Shoshana H. Ballew, Aditya Surapaneni, Kunihiro Matsushita, Henk J.G. Bilo, Juan J. Carrero, Gabriel Chodick, Kenn B. Daratha, Simerjot K. Jassal, Girish N. Nadkarni, Robert G. Nelson, Christoph Nowak, Nikita Stempniewicz, Keiichi Sumida, Jamie P. Traynor, Mark Woodward, Yingying Sang, Ron T. Gansevoort, John Chalmers, Katherine Tuttle, Radica Alicic, Sterling McPherson, Cami Jones, Gurmukteshwar Singh, Jamie Green, H. Lester Kirchner, Varda Shalev, Erwin P. Bottinger, Ruth J.F. Loos, Stephen B. Ellis, John Cuddeback, Elizabeth Ciemins, Emily Carbonara, Stephan Dunning, William C. Knowler, Helen C. Looker, Lyane M. Kieneker, Stephan J.L. Bakker, Hans L. Hillege, Pim van der Harst, Jacklyn Bergstrom, Joachim Ix, Csaba P. Kovesdy, Praveen Potukuchi, Marco Trevisan, Carl Gustaf Elinder, Björn Wettermark, Johan Ärnlöv, Patrick B. Mark, Peter C. Thomson, Colin C. Geddes, Gijs W.D. Landman, Kornelis J.J. van Hateren, Nanne Kleefstra, Orlando Gutierrez, Tsuneo Konta, Andrew S. Levey, Kevan Polkinghorne, Elke Schäffner, Jingsha Chen, Aditya Surapeneni, Groningen Kidney Center (GKC), and Cardiovascular Centre (CVC)
- Subjects
Adult ,medicine.medical_specialty ,Article ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,Diabetes Mellitus ,Medicine ,Albuminuria ,Humans ,Renal Insufficiency, Chronic ,Aged ,business.industry ,Incidence (epidemiology) ,Odds ratio ,Middle Aged ,medicine.disease ,Blood pressure ,Meta-analysis ,Creatinine ,Cohort ,Hypertension ,medicine.symptom ,business ,Kidney disease ,Glomerular Filtration Rate - Abstract
Albuminuria is an under-recognized component of chronic kidney disease definition, staging, and prognosis. Guidelines, particularly for hypertension, conflict on recommendations for urine albumin-to-creatinine ratio (ACR) measurement. Separately among 1 344 594 adults with diabetes and 2 334 461 nondiabetic adults with hypertension from the chronic kidney disease Prognosis Consortium, we assessed ACR testing, estimated the prevalence and incidence of ACR ≥30 mg/g and developed risk models for ACR ≥30 mg/g. The ACR screening rate (cohort range) was 35.1% (12.3%–74.5%) in diabetes and 4.1% (1.3%–20.7%) in hypertension. Screening was largely unrelated to the predicted risk of prevalent albuminuria. The median prevalence of ACR ≥30 mg/g across cohorts was 32.1% in diabetes and 21.8% in hypertension. Higher systolic blood pressure was associated with a higher prevalence of albuminuria (odds ratio [95% CI] per 20 mm Hg in diabetes, 1.50 [1.42–1.60]; in hypertension, 1.36 [1.28–1.45]). The ratio of undetected (due to lack of screening) to detected ACR ≥30 mg/g was estimated at 1.8 in diabetes and 19.5 in hypertension. Among those with ACR
- Published
- 2021